Systematic Review

The impact of health information technologies, such as electronic health records, on the quality, efficiency and cost of clinical care was examined in this article. A systematic review of the research literature was conducted and database searches including MEDLINE and the Cochrane Central Register of Controlled Trials. Additional studies earmarked by experts in the field were reviewed. A total of 257 articles were included in the study.

Key Findings:

Benchmark research leaders were those institutions that were responsible for 5 percent or more of the 257 articles reviewed. Four benchmark institutions were identified. These institutions accounted for 24 percent of the articles reviewed.

Almost half of the studies reviewed were of outpatient settings. Most studies focused on decision support systems (63%) and electronic health records (37%).

Data on the costs of multifunctional health information technologies on clinical care was scarce.

The efficiency of multifunctional health care technologies in regard to clinical care was observed in lower utilization of care with mixed results for time utilization.

The impact of multifunctional health care technologies on quality of clinical care was seen in an increase in following protocols during provision of care, enhancements in surveillance and monitoring, and fewer medication errors.

Evaluations of commercially developed, multifunctional systems were found in just nine studies.